Objective The aim of this study is to review the association between long non-coding RNA (lncRNA) and papillary thyroid carcinoma (PTC). Method The relevant literatures about lncRNA associated with PTC were retrospectively analyzed and summarized. Results The expression levels of noncoding RNA associated with MAP kinase pathway and growth arrest (NAMA), PTC susceptibility candidate 3 (PTCSC3), BRAF activated non-coding RNA (BANCR), maternally expressed gene 3 (MEG3), NONHSAT037832, and GAS8-AS1 in PTC tissues were significantly lower than those in non-thyroid carcinoma tissues. The expression levels of ENST00000537266, ENST00000426615, XLOC051122, XLOC006074, HOX transcript antisense RNA (HOTAIR), antisense noncoding RNA in the INK4 locus (ANRIL), and metastasis-associated lung adenocarcinoma transcript 1 (MALAT1) in PTC tissues were upregulated in PTC tissues, comparing with the non-thyroid carcinoma tissues. These lncRNAs were possibly involved in cell proliferation, migration, and apoptosis of PTC. Conclusion LncRNAs may provide new insights into the molecular mechanism and gene-targeted therapy of PTC and become new molecular marker for the diagnosis of PTC.
ObjectiveTo investigate the risk factors for central lymph node metastasis (CLNM) in patients with clinically negative lymph node (cN0 stage) papillary thyroid carcinoma (PTC).MethodsThe clinicopathological data of 250 patients with cN0 PTC who underwent thyroidectomy and central lymph node dissection (CLND) in Department of General Surgery of Xuzhou Central Hospital from June 2016 to June 2019 were retrospectively analyzed. The influencing factors of CLNM in patients with cN0 PTC were analyzed by univariate analysis and binary logistic regression, and then R software was used to establish a nomogram prediction model, receiver operating characteristic curve was used to evaluate the differentiation degree of the model, and Bootstrap method was used for internal verification to evaluate the calibration degree of the model.ResultsCLNM occurred in 147 of 250 patients with cN0 PTC, with an incidence of 58.8%. Univariate analysis showed that multifocal, bilateral, tumor diameter, and age were correlated with CLNM (P<0.01). The results of binary logistic regression analysis showed that multifocal, bilateral tumors, age≥45 years old, and tumor diameter>1 cm were independent risk factors for CLNM in patients with cN0 PTC (P<0.05). The area under the curve (AUC) of the nomogram prediction model established on this basis was 0.738, and the calibration prediction curve in the calibration diagram fitted well with the ideal curve.ConclusionsCLNM is more likely to occur in PTC. The nomogram model constructed in this study can be used as an auxiliary means to predict CLNM in clinical practice.
ObjectiveTo explore the location and characteristics of postoperative recurrence of papillary thyroid carcinoma. MethodsThe clinical data of 96 patients who underwent reoperation for papillary thyroid cancer at the Affiliated Cancer Hospital of Zhengzhou University from January 2017 to March 2024 were retrospectively analyzed. ResultsOut of 96 patients, 3 had thyroid recurrence, 89 had lymph node recurrence, and 4 had thyroid and lymph node recurrence. There were 69 cases of single recurrence and 27 cases of multiple recurrence. Ten cases underwent lobectomy and lateral area cleaning, 8 cases underwent central area cleaning, 33 cases underwent lateral area cleaning, and 45 cases underwent central area+lateral area cleaning. Postoperative pathological examination revealed that there was lymph node metastasis in 93 cases (16 cases in the central region, 44 cases in the lateral region, and 33 cases in both the central and lateral regions), with 3 cases remaining non metastatic; 58 cases had extracapsular invasion of lymph nodes. Compared with patients with multiple relapses, patients with single recurrence had younger age (t=–3.385, P=0.001), lower incidence of gross extracapsular invasion of lymph nodes during surgery (χ2=6.970, P=0.008), higher number of metastatic lymph nodes (t=4.034, P=0.001), and higher rate of lymph node metastasis in zones Ⅱ, Ⅲ, and Ⅳ (χ2=8.142, P=0.004; χ2=6.357, P=0.012; χ2=12.547, P<0.001). ConclusionsPostoperative recurrence of papillary thyroid cancer is mainly due to lymph node recurrence. The advanced age and the visible lymph node extracapsular invasion may increased risk of postoperative recurrence of papillary thyroid cancer. Lymph node metastasis in the central region is a possible cause of multiple relapses and surgeries.
ObjectiveTo explore the influencing factors affecting lymph nodes posterior to the right recurrent laryngeal nerve (LN-prRLN) metastasis in papillary thyroid carcinoma (PTC) and construct a clinical nomogram prediction model to provide a reference for LN-prRLN dissection decision-making. MethodsThe clinical data of PTC patients admitted to the General Surgery Department of Baoding No.1 Central Hospital from January 2021 to December 2023 were retrospectively analyzed. Among them, 325 patients underwent LN-prRLN dissection, and they were divided into non-metastatic group (269 cases) and metastasis group (56 cases) according to the presence or absence of LN-prRLN metastasis. By comparing the differences of clinical and pathological characteristics between the two groups, the risk factors of LN-prRLN metastasis were analyzed and discussed, and then the nomogram prediction model of LN-prRLN metastasis was constructed with the risk factors, and the effectiveness of the model was verified and evaluated. ResultsIn 325 patients, 56 cases (17.23%) occurred LN-prRLN metastasis. The results of univariate analysis showed that gender, extrathyroidal extension, lymph nodes anterior to right recurrent laryngeal nerve (LN-arRLN) metastasis, location of cancer focus, and lateral lymph node metastasis (LLNM) were related to LN-prRLN metastasis of PTC (P<0.05). Multivariate binary logistic regression analysis showed that male [OR=3.878, 95%CI (1.192, 12.615)], with extrathyroidal extension [OR=2.836, 95%CI (1.036, 7.759)], with LN-arRLN metastasis [OR=10.406, 95%CI (3.225, 33.926)], right cancer focus [OR= 5.632, 95%CI (1.812, 17.504)] and with LLNM [OR=3.426, 95%CI (1.147, 10.231)] were the risk factors of LN-prRLN metastasis. Receiver operating characteristic curves of nomogram prediction model based on the above risk factors showed that the area under the curve was 0.865, 95%CI was (0.795, 0.934), Jordan index was 0.729, sensitivity was 0.873, and specificity was 0.856, which had higher prediction value. The C-index of Bootstrap test was 0.840 [95%CI (0.755, 0.954) ]. Calibration curves showed that predictive value close to the ideal curve, had good consistency. The clinical decision curve analysis showed that the model had good clinical prediction effect on LN-prRLN metastasis of PTC. ConclusionsMale, extrathyroidal extension, LN-arRLN metastasis, right cancer focus and LLNM are independent risk factors for LN-prRLN metastasis of PTC. The nomogram prediction model based on the above independent risk factors has high discrimination and calibration, which is helpful for surgeons to make clinical decisions.
ObjectiveTo investigate the correlation between the expressions of bone morphogenetic protein 4 (BMP4) and sma and mad homologue 4 (Smad4) and their clinicopathological features in papillary thyroid carcinoma (PTC).MethodsEighty patients with PTC confirmed by pathology in the Pingdingshan Second People’s Hospital from March 2018 to March 2020 were selected as the research objects, the cancer tissues and adjacent tissues removed during surgery were collected. The mRNA expression levels of BMP4 and Smad4 were detected by real-time quantitative PCR (qRT-PCR). The correlation between BMP4 and Smad4 mRNA expression levels was analyzed by Pearson method. The expressions of BMP4 and Smad4 protein were detected by immunohistochemistry. The correlation between the expressions of BMP4 and Smad4 protein and clinicopathological features of PTC was analyzed.ResultsThe mRNA expression levels of BMP4 and Smad4 in PTC tissues were lower than those in adjacent tissues (P<0.05). Pearson analysis showed that there was a positive correlation between expressions of BMP4 mRNA and Smad4 mRNA in PTC cancer (r=0.660, P<0.05). BMP4 and Smad4 protein were localized in cytoplasm, and the cytoplasm was stained yellow or brown yellow. The results of immunohistochemistry showed that the expression positive rate of BMP4 in cancer tissues of PTC patients was lower than that in adjacent tissues (18.8% vs 97.5%, χ2=101.916, P<0.05), and the expression positive rate of Smad4 protein in cancer tissues of PTC patients was also lower than that in adjacent tissues (11.3% vs 93.8%, χ2=109.173, P<0.05). The expressions of BMP4 and Smad4 protein in PTC patients were correlated with the tumor size, TNM stage, lymph node metastasis, degree of infiltration and multiple foci (P<0.05).ConclusionsThe expression levels of BMP4 mRNA and Smad4 mRNA in PTC tissues are decreased, and the expression of BMP4 protein and Smad4 protein are closely related to tumor size, TNM stage and lymph node metastasis, which may be used as new therapeutic targets.
Objective To investigate the expressions and clinical significance of Notch-2 protein and Numb protein in papillary thyroid carcinoma (PTC). Methods PTC tissues and its para-cancerous tissues of 50 patients with PTC who treated in The Affiliated Hospital of Inner Mongolia University for Nationalities from Mar. 2014 to Mar. 2017 were retrospectively collectied, to detect the expressions of Notch-2 protein and Numb protein by immunohistochenmical method. Results ① Expressions of Notch-2 protein and Numb protein in PTC tissues and para-cancerous tissues: the positive-expression rate of Notch-2 protein in PTC tissues was 82.00% (41/50), which was higher than that of para-cancerous tissues〔18.00% (9/50)〕, the difference was statistically significant (χ2=40.960, P<0.001). The positive-expression rate of Numb protein in PTC tissues was 66.00% (33/50), which was higher than that of para-cancerous tissues 〔0 (0/50) 〕, the difference was statistically significant (χ2=49.254, P<0.001). ② The relationship between expression of Notch-2 protein and expression of Numb protein in PTC tissues: there was a positive correlation between expressions of Notch-2 protein and Numb protein in PTC tissues (rs=0.323, P=0.022). ③ The relationship between expressions of Notch-2 protein and Numb protein in PTC tissues and clinicopathological features of the PTC patients: the expression of Notch-2 protein in PTC tissues was not significantly correlated with gender, age, tumor diameter, capsule infiltration, cervical lymph node metastasis, and TNM staging (P>0.05). The expression of Numb protein in PTC tissues was not significantly correlated with gender, age, tumor diameter, and capsule infiltration (P>0.05), but was significantly correlated with cervical lymph node metastasis and TNM staging (P<0.05), the positive rates of Numb protein in patients of staging Ⅲ+Ⅳ group and cervical lymph node metastasis group were lower than those of patients in staging Ⅰ+Ⅱ group and non-cervical lymph node metastasis group. Conclusion The positive-expression rate of Notch-2 protein and Numb protein in PTC tissues are higher than those of para-cancerous tissues, and there is a positive correlation between them in PTC tissues, suggesting that there may be a synergistic effect in the course of PTC progression.
ObjectiveTo understand the molecular mechanisms underlying the carcinogenesis and progression of papillary thyroid carcinoma (PTC), and provide candidate targets for diagnosis and treatment of PTC.MethodsTo identify the differentially expressed genes (DEGs) in the carcinogenesis and progression of PTC, the study was carried by analyzing the microarray datasets downloaded from gene expression omnibus (GEO) database, and making a series of studies including the protein-protein interaction network, KEGG and GO enrichment analyses of DEGs.ResultsA total of 339 DEGs and 10 hub genes were identified. While the expression of KIT was downregulated in the samples of PTC, the figures for FN1, CCND1, TIMP1, ICAM1, APOE, MET, RUNX2, KRT19 and SERPINA1 were upregulated. After the hypothesis test was corrected by multiple tests, the results showed that the changes of APOE [false discovery rate (FDR)=0.047 5] and KIT (FDR=0.042 0) gene expression had a certain impact on recurrence free survival (RFS) of PTC patients, which was statistically significant.ConclusionsSurvival analysis showed that FN1, ICAM1, APOE, MET, KRT19, KIT and SERPINA1 may be involved in the carcinogenesis or prognosis of PTC. However, further studies are needed to elucidate the biological function of these genes in PTC.
ObjectiveTo investigate association between BRAFV600E gene mutation and extrathyroidal extension (ETE) among patients with papillary thyroid carcinoma (PTC).MethodsA retrospective study was conducted to collect all PTC surgical patients in the Renmin Hospital of Wuhan University from 2017 to 2019. The patients tested for BRAFV600E gene mutation were selected, and the association between BRAFV600E gene mutation and ETE were analyzed.ResultsThe BRAFV600E gene mutation test was performed only in 273 cases, 223 and 50 of whom were BRAFV600E gene with and without mutation, respectively; 194 and 79 of whom had ETE and no ETE, respectively. Univariate analysis showed that the incidence rate with BRAFV600E gene mutation was higher in the patients with ETE as compared with the patients without ETE (86.1% vs 70.9%, P=0.003) and the incidence rate of ETE was higher in the patients with BRAFV600E gene mutaton than in the patients without BRAFV600E gene mutaton (74.9% vs 54.0%, P=0.003). In addition, the incidence rates of ETE in the patients with tumor diameter >1 cm, bilaterality, and multifocality were higher than those in the patients with tumor diameter ≤1 cm (86.7% vs 61.3%, P<0.001), unilaterality (89.6% vs 63.8%, P<0.001), and single lesion (85.7% vs 60.9%, P<0.001), respectively. The incidence rate of ETE was increased with the increase of lymph node stage (P=0.003). Multivariate logistic regression analysis showed tumor size >1 cm [OR=3.606, 95%CI (1.758, 7.396), P<0.001], multifocality [OR=2.524, 95%CI (1.154, 5.519), P=0.020], with BRAFV600E gene mutaton [OR=3.022, 95%CI (1.443, 6.326), P=0.003] were the risk factors for ETE.ConclusionThe preliminary results of this study suggest that PTC patients with BRAFV600E gene mutaton are more likely to gross ETE.
Objective To analyze the expression differences of FoxP3 protein in papillary thyroid carcinoma (PTC) and nodular goiter, and to explore the correlation between FoxP3 and the clinicopathological characteristics of PTC patients and the therapeutic dose of 131I. Methods Immunohistochemical method was used to detect the expression of FoxP3 protein in 128 cases of PTC tissues (42 cases were treated with 131I after operation) and 20 cases of nodular thyroid tissues, and the relationship between it and the clinicopathological characteristics of PTC patients and the dose of 131I treatment was also analyzed. Results The positive rate of FoxP3 protein expression in PTC tissues was 46.09%, which was higher than that in nodular goiter tissues (0.00%), and the difference was statistically significant (P<0.001). The expression of FoxP3 protein in PTC was correlated with gender, extraglandular invasion and tumor diameter (P values were 0.041, 0.039, and 0.007, respectively), but had no correlation with age, capsular invasion, TNM staging, lymph node metastasis, and distant metastasis (P>0.05). The results of binary logistic regression analysis suggest that tumor diameter was an independent risk factor affecting FoxP3 protein expression [OR=0.389, 95%CI (0.180, 0.840), P=0.016]. By drawing the receiver operating characteristic (ROC) curve, it was shown that the area under the curve (AUC) was 0.643 when the tumor diameter was 1.05 cm, the sensitivity to predict the increase in FoxP3 protein expression was 64.41%, and the specificity was 57.97%, P=0.006. Among 42 patients with PTC who underwent 131I treatment after surgery, the therapeutic dose of 131I was related to the expression of FOXP3 protein (P=0.031). It was shown that patients with positive expression of FoxP3 protein were given more dose of 131I after surgery. Conclusions The positive rate of FoxP3 protein expression in PTC is higher than that of nodular goiter. Its high expression means that the patient has poor pathological characteristics and larger 131I treatment dose, suggesting that FoxP3 may be involved in the malignant progression of PTC.
ObjectiveTo summarize the research progress of related genes in Hashimoto’s thyroiditis with papillary thyroid carcinoma.MethodLiteratures about Hashimoto’s thyroiditis with papillary thyroid carcinoma were reviewed by searching the literatures in domestic and foreign database.ResultsIn recent years, the incidence of Hashimoto’s thyroiditis with thyroid carcinoma (especially papillary thyroid carcinoma) was on the increase, the two might have the same molecular pathology mechanism.ConclusionThere is a close association between Hashimoto’s thyroiditis and papillary thyroid carcinoma, the common molecular genetic changes suggest that Hashimoto’s thyroiditis may have a correlation with papillary thyroid carcinoma.